Individual provider · Type 1 NPI
Johanna Derisca
Acute Care Nurse Practitioner · New York, NY
NPI number
1205639895
Active
Practice location
506 Lenox Ave
New York, NY 10037-1802
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner Primary | 363LA2100X | 432908 (NY) |
Acute Care Nurse Practitioner: Definition to come...
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About NPI 1205639895
Johanna Derisca's National Provider Identifier is 1205639895, issued on Mar 29, 2025. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in New York, NY. The record was last updated on Mar 29, 2025.